36-Month follow-up of 75 renal allograft recipients treated with steroids, tacrolimus, and azathioprine or mycophenolate mofetil

Mucha, Krzysztof; Foroncewicz, Bartosz; Pączek, Leszek; Pazik, J.; Lewandowska, Dorota; Krawczyk, Agnieszka; Pliszczyński, Jacek; Gradowska, L; Durlik, M.; Wałaszewski, J; Nazarewski, Sławomir; Szmidt, J

doi:10.1016/s0041-1345(03)00815-7

Cited by 10 publications

(4 citation statements)

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“…The use of MMF in kidney transplantation has been associated with a clear benefit in terms of reducing acute rejection rates (3,8,15,16), while in heart transplantation a reduction in the manifestation of so-called "chronic rejection" was seen in MMFtreated patients (17). Not all of these studies, however, have been prospective, randomized, controlled trials analyzed according to intention to treat.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Mycophenolate Mofetil and Azathioprine for Prevention of Bronchiolitis Obliterans Syndrome in De Novo Lung Transplant Recipients

McNeil¹,

Glanville²,

Wahlers³

et al. 2006

Transplantation

122

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Section: Discussionmentioning

confidence: 99%

Comparison of Mycophenolate Mofetil and Azathioprine for Prevention of Bronchiolitis Obliterans Syndrome in De Novo Lung Transplant Recipients

McNeil¹,

Glanville²,

Wahlers³

et al. 2006

Transplantation

122

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“…Additionally, it should be pointed out that although the present study used tacrolimus to normalize glycemic control in the obese and T2DM mice, a paradoxical new-onset diabetes after transplantation (NODAT), a severe complication following organ transplantation, has been reported to occur in between 2 and 53% of transplanted patients receiving higher dosing of tacrolimus and/or having pretransplantation hyperglycemia (reviewed in [ 43 – 45 ]. Nonetheless, NODAT has not been reported in recent studies on allogeneic uterine transplantation in rats receiving low dosing of tacrolimus [ 46 ], neither was it associated with worsening of clinical outcomes during a mean follow-up of 3 years in kidney transplant recipients [ 47 ]; nevertheless it is warranted that further pre-clinical safety studies on the potential use of tacrolimus as anti-diabetic agent should be conducted.…”

Section: Discussionmentioning

confidence: 99%

Tacrolimus in the prevention of adverse pregnancy outcomes and diabetes-associated embryopathies in obese and diabetic mice

et al. 2017

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BackgroundT2DM is a high-risk pregnancy with adverse fetal and maternal outcomes including repeated miscarriages and fetal malformations. Despite the established association between placental insufficiency and poor maternal Th1-adaptability to the development of pregnancy complications in T2DM, there have been no established data to assess benefits of pre-pregnancy immunosuppression relative to gestational outcomes in T2DM. We hypothesized that pre-pregnancy macrolide immune suppression can re-establish normal placental development and uterine vascular adaptation in a mouse model of obesity-associated T2DM.MethodsFetal live birth rate, postnatal variability, mid-gestational uterine and umbilical flow dynamics and certain morphological features of spiral artery modification were examined in the New Zealand Obese (NONcNZO10/Ltj) female mice (n = 56) weaned to ages of 32 weeks on a 60% calories/g high-fat diet (also referred to as HFD-dNONcNZO), and which received either tacrolimus (0.1 mg/kg s.c. q2d) , its vehicle (castor oil and ethanol) or metformin (in drinking water 200 mg/dL p.o. ad libitum). HFD-BALBc-Rag2/IL2-gc female mice (n = 24) were used as HFD-immunodeficient controls.ResultsTreatment of the HFD-dNONcNZO female mice with tacrolimus improved live birth rates and postnatal viability scores (p < 0.01), normalized OGTT (p < 0.001), inhibited fetal malformation rates, restored morphology of spiral arterial modification; and improved uterine arterial and umbilical blood flow (p < 0.01). Placental production of TNFαand IL16 in the tacrolimus-treated HFD-dNONcNZO dams were restored to non-diabetic levels and the treatment resulted in the inhibition of aberrant monocyte/macrophage activation during pregnancy in the HFD-dNONcNZO dams.ConclusionsOur present data suggest a casual association between chronic maternal overnutrition and aberrancy in the maternal Th1-immune maladaptation to pregnancy and defective spiral artery modification, placental insufficiency and adverse fetal outcomes in the T2DM subjects. Further safety studies into the use of tacrolimus in the pre-pregnancy glycemic control may be beneficial.Electronic supplementary materialThe online version of this article (doi:10.1186/s12967-017-1137-4) contains supplementary material, which is available to authorized users.

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“…Some studies reported that graft survival and acute rejection episodes were similar between AZA-and MMF-treated groups. 32,33 On the other hand, Ojo et al demonstrated that patients without acute rejection episodes, the risk of chronic allograft failure was 20% lower in the MMF group compared with the AZA group. 34 Therefore, the medical treatment continued during follow-up in the study group may have caused suspicious subclinical allograft failure.…”

Section: Preeclampsia 8 38mentioning

confidence: 99%

Obstetric and long‐term graft outcomes in pregnant kidney transplant recipients: A single‐center experience

Akcay

Yeter

Karçaaltıncaba

et al. 2021

Clinical Transplantation

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End-stage renal disease (ESRD) significantly affects fertility in women of childbearing age. 1 Kidney transplantation (KT) is the best option for many women with ESRD desiring pregnancy, as it rapidly restores the hypothalamic-pituitary-gonadal axis function and increases fertility. With gradual improvement in the graft and patient survival and quality of life, pregnancy incidence has increased in KT patients in recent decades. So, reported live birth rates are 73%-80% in KT recipients. [2][3][4] Based on a recent in-depth systematic review, pregnancy after transplantation seems to be safe. 3 Although these pregnancies significantly have better outcomes than patients under dialysis treatment, serious complications are still observed. 5,6 Studies have demonstrated more maternal complications with higher rates of hypertension, preeclampsia, and cesarean sections in KT recipient women. 3,5 Fetal complications resulting with perinatal

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36-Month follow-up of 75 renal allograft recipients treated with steroids, tacrolimus, and azathioprine or mycophenolate mofetil

Cited by 10 publications

References 1 publication

Comparison of Mycophenolate Mofetil and Azathioprine for Prevention of Bronchiolitis Obliterans Syndrome in De Novo Lung Transplant Recipients

Comparison of Mycophenolate Mofetil and Azathioprine for Prevention of Bronchiolitis Obliterans Syndrome in De Novo Lung Transplant Recipients

Tacrolimus in the prevention of adverse pregnancy outcomes and diabetes-associated embryopathies in obese and diabetic mice

Obstetric and long‐term graft outcomes in pregnant kidney transplant recipients: A single‐center experience

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